Comparison of Two Combined Therapeutic Methods for Treatment of Lateral Epicondylitis

Inclusion Criteria: * pain at the lateral side of the elbow * pain at the lateral epicondyle during resisted dorsiflexion of the wrist with the elbow in full extension, or resisted extension of middle finger at the metacarpophalangeal joint * pain to be continued for longer than 6 weeks or even with recurrent pain during similar period Exclusion Criteria: * previous history of receiving any treatment for lateral epicondylitis within 6 months prior to intervention * patients who were unable to return for follow up * patients with nerve entrapment * pregnancy * breast-feeding * presence of systemic neuromuscular disorders such as myasthenia gravis * upper limb fractures * other arm/forearm pathology such as radial nerve compression * known thrombocytopenia * coagulopathy or bleeding diathesis * history of diffuse pain syndrome * history of inflammatory arthropathy * intolerance/allergy to corticosteroids or NSAIDs or any contraindication for these * untreated depression * history of narcotic use for pain management greater than 1 month or history of narcotic abuse problem